NPIMap

Organization Active NPI

Desoto Family Dental Care,PA

  • General Practice Dentistry
  • Hernando, MS
National Provider Identifier
1124245444
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1472-71 Issued in MS
Legal business name
DESOTO FAMILY DENTAL CARE,PA
Practice address
460 Byhalia Rd
Hernando, MS 38632-1319
Phone
(662) 429-5239
Fax
(662) 449-0758
NPI assigned
Apr 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Shirley S Seymour
Title
Secretary
Phone
(662) 429-5239

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 1472-71 MS Primary

Addresses

Primary practice location

460 Byhalia Rd
Hernando, MS 38632-1319

Mailing address

460 Byhalia Rd
Hernando, MS 38632-1319
Phone (662) 429-5239

National Provider Directory

National Provider Directory

Locations

460 Byhalia Rd
Hernando, MS 38632
Phone (662) 429-5239

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124245444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 BYHALIA RD",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "386321319",
            "telephone_number": "662-429-5239",
            "fax_number": "662-449-0758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 BYHALIA RD",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "386321319",
            "telephone_number": "662-429-5239",
            "fax_number": "662-449-0758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESOTO FAMILY DENTAL CARE,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SEYMOUR",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "662-429-5239",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "1472-71",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hernando, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.